AIM:The aim of the study was to understand why nurses leave nursing practice in China by exploring the process from recruitment to final exit. This report examines the impact of safety and quality of health care on nursing career decision-making from the leavers' perspective.
BACKGROUND:The nursing shortage in China is more serious than in most developed countries, but the loss of nurses through voluntarily leaving nursing practice has not attracted much attention.
METHOD:This qualitative study draws on a grounded theory approach. In-depth interviews with 19 nurses who have left nursing practice and were theoretically sampled from one provincial capital city in Mainland China.
FINDING:'Loss of confidence in the safety and quality of health care' became one of the main categories from all leavers' accounts of their decision to leave nursing practice. It emerged from three themes 'Perceiving risk in clinical practice', 'Recognising organisational barriers to safety' and 'Failing to meet expectations of patients'.
DISCUSSION:The findings indicate that the essential work value of nursing to the leavers is the safety and quality of care for their patients. When nurses perceived that they could not fulfil this essential work value in their nursing practice, some of them could not accept the compromise to their value of nursing and left voluntarily to get away from the physical and mental stress. However, some nurses had to stay and accept the limitations on the safety and quality of health care.
CONCLUSION:The study suggests that well-qualified nurses voluntarily leaving nursing practice is a danger signal for patients and hospitals, and has caused deterioration in nursing morale for both current and potential nursing workforces. It suggests that safety and quality of health care could be improved when individual nurses are empowered to exercise nursing autonomy with organisational and managerial support.
IMPLICATIONS FOR NURSING MANAGEMENT:The priority retention strategies need to remove organisational barriers to the safety and quality of health care. Under the current nursing shortage, Chinese hospital managers might consider recruiting nurses and care assistants of different educational levels, which would effectively improve nursing team work and support nurses' to stay and actively achieve their work values for the safety and quality of health care.
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【The impact of safety and quality of health care on Chinese nursing career decision-making.].
【安全和卫生保健质量对中国护理职业决策的影响。】
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DOI：10.1111/jonm.12140文章类型：杂志文章
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目的：该研究的目的是通过探索从招聘到最终离职的过程，了解为什么护士离开中国的护理实践。本报告从毕业生的角度考察了安全性和医疗质量对护理职业决策的影响。
背景：中国的护理短缺情况比大多数发达国家更为严重，但是由于自愿离开护理实践而造成的护士流失并没有引起人们的广泛关注。
方法：本定性研究借鉴了扎根的理论方法。对19位已经离开护理实践的护士进行的深入访谈，理论上是从中国大陆一个省会城市抽取的。
结果：从所有离开者关于离开护理实践的决定的叙述中，“对医疗安全性和质量的信心丧失”已成为主要类别之一。它来自三个主题：“在临床实践中意识到风险”，“认识到组织对安全性的障碍”和“未能满足患者的期望”。
讨论：研究结果表明，为离职者提供护理的基本工作价值是为其患者提供护理的安全性和质量。当护士认为自己无法在护理实践中实现这一基本工作价值时，其中一些人便无法接受对其护理价值的妥协，因此自愿离开以摆脱身心压力。但是，一些护士不得不留下来并接受医疗保健安全性和质量的限制。
结论：该研究表明，合格的护士自愿离开护理实践对患者和医院来说是一个危险信号，并已导致当前和潜在护理人员的护理士气下降。它表明，如果个人护士在组织和管理支持下被赋予行使护理自主权的权利，则可以提高医疗保健的安全性和质量。
护理管理的含义：优先级保留策略需要消除对医疗保健安全和质量的组织障碍。在当前护理短缺的情况下，中国医院管理人员可能会考虑招募不同文化程度的护士和护理助手，这将有效地改善护理团队的工作，并支持护士留下来并积极实现其工作价值，以确保医疗的安全性和质量。
背景：中国的护理短缺情况比大多数发达国家更为严重，但是由于自愿离开护理实践而造成的护士流失并没有引起人们的广泛关注。
方法：本定性研究借鉴了扎根的理论方法。对19位已经离开护理实践的护士进行的深入访谈，理论上是从中国大陆一个省会城市抽取的。
结果：从所有离开者关于离开护理实践的决定的叙述中，“对医疗安全性和质量的信心丧失”已成为主要类别之一。它来自三个主题：“在临床实践中意识到风险”，“认识到组织对安全性的障碍”和“未能满足患者的期望”。
讨论：研究结果表明，为离职者提供护理的基本工作价值是为其患者提供护理的安全性和质量。当护士认为自己无法在护理实践中实现这一基本工作价值时，其中一些人便无法接受对其护理价值的妥协，因此自愿离开以摆脱身心压力。但是，一些护士不得不留下来并接受医疗保健安全性和质量的限制。
结论：该研究表明，合格的护士自愿离开护理实践对患者和医院来说是一个危险信号，并已导致当前和潜在护理人员的护理士气下降。它表明，如果个人护士在组织和管理支持下被赋予行使护理自主权的权利，则可以提高医疗保健的安全性和质量。
护理管理的含义：优先级保留策略需要消除对医疗保健安全和质量的组织障碍。在当前护理短缺的情况下，中国医院管理人员可能会考虑招募不同文化程度的护士和护理助手，这将有效地改善护理团队的工作，并支持护士留下来并积极实现其工作价值，以确保医疗的安全性和质量。
